Individual
MIAH MICHEL FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
700 W. 23RD STREET, SUITE 100, PANAMA CITY, FL 32401
(850) 747-5411
(850) 747-5583
Mailing address
700 W. 23RD STREET, SUITE 100, PANAMA CITY, FL 32401
(850) 747-5411
(850) 747-5583
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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